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WO2016006463A1 - Sonde ultrasonore et dispositif de traitement par ultrasons - Google Patents

Sonde ultrasonore et dispositif de traitement par ultrasons Download PDF

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Publication number
WO2016006463A1
WO2016006463A1 PCT/JP2015/068335 JP2015068335W WO2016006463A1 WO 2016006463 A1 WO2016006463 A1 WO 2016006463A1 JP 2015068335 W JP2015068335 W JP 2015068335W WO 2016006463 A1 WO2016006463 A1 WO 2016006463A1
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WO
WIPO (PCT)
Prior art keywords
vertical direction
ultrasonic probe
ultrasonic
hook
protrusion
Prior art date
Application number
PCT/JP2015/068335
Other languages
English (en)
Japanese (ja)
Inventor
庸高 銅
Original Assignee
オリンパス株式会社
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by オリンパス株式会社 filed Critical オリンパス株式会社
Priority to EP15819625.3A priority Critical patent/EP3167832B1/fr
Priority to CN201580017413.3A priority patent/CN106132327B/zh
Priority to JP2016506020A priority patent/JP5970142B2/ja
Publication of WO2016006463A1 publication Critical patent/WO2016006463A1/fr
Priority to US15/265,959 priority patent/US10064641B2/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320072—Working tips with special features, e.g. extending parts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320072—Working tips with special features, e.g. extending parts
    • A61B2017/320078—Tissue manipulating surface
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320082—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic for incising tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320089—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic node location
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
    • A61B2017/320095—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw with sealing or cauterizing means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320098—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with transverse or torsional motion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00994—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body combining two or more different kinds of non-mechanical energy or combining one or more non-mechanical energies with ultrasound

Definitions

  • the present invention relates to an ultrasonic probe capable of transmitting ultrasonic vibration from a proximal direction to a distal direction, and an ultrasonic treatment instrument including the ultrasonic probe.
  • Patent Document 1 discloses an ultrasonic treatment instrument including an ultrasonic probe capable of transmitting ultrasonic vibration from a proximal direction to a distal direction.
  • the distal end portion of the ultrasonic probe is provided with a distal end treatment portion that treats a treatment target such as a biological tissue using the transmitted ultrasonic vibration.
  • the distal treatment portion is formed with a hook portion that protrudes in one direction (first vertical direction) perpendicular to the longitudinal axis. A part of the tip surface of the ultrasonic probe is formed by the hook portion.
  • the ultrasonic probe (treatment unit) vibrates by ultrasonic vibration while the treatment target is hooked on the hook portion from the proximal direction side, so that the treatment target hooked on the hook portion is excised. In a state where ultrasonic vibration is transmitted, the ultrasonic probe performs longitudinal vibration whose vibration direction is parallel to the longitudinal axis.
  • a hook portion that forms a part of the tip surface of the ultrasonic probe is provided, and the hook portion protrudes in one direction perpendicular to the longitudinal axis.
  • the ultrasonic probe performs longitudinal vibration whose vibration direction is parallel to the longitudinal axis by ultrasonic vibration.
  • a moment is generated around the base position of the protrusion.
  • the generated moment causes the hook portion to oscillate around the base position of the protrusion.
  • the moment causing the hook portion to oscillate also acts on portions other than the hook portion in the distal treatment portion.
  • the present invention has been made paying attention to the above-mentioned problems, and the object of the present invention is to ensure the stability of vibration due to ultrasonic vibration even in a configuration in which a hook portion forming a part of the tip surface is provided. It is to provide an ultrasonic probe. Moreover, it is providing the ultrasonic treatment tool provided with the ultrasonic probe.
  • an aspect of the present invention is an ultrasonic probe having a longitudinal axis that extends along the longitudinal axis and transmits ultrasonic vibration from a proximal direction to a distal direction.
  • a first vertical direction with respect to the probe main body when the main body and one of the directions perpendicular to the longitudinal axis are defined as a first vertical direction, provided on the distal direction side of the probe main body.
  • the base portion of the hook portion extends from the hook base end, which is a boundary position between the base of the protruding portion of the hook portion and the base bottom surface, toward the base end, and the first portion from the longitudinal axis.
  • the vertical distance of 1 is the length A first basal surface that is constant in a predetermined dimension over the entire length in the longitudinal direction along the axis, and a second surface that is provided on an outer surface facing a second vertical direction that is opposite to the first vertical direction.
  • an ultrasonic probe in which the stability of vibration due to ultrasonic vibration is ensured even in a configuration in which a hook portion that forms a part of the tip surface is provided.
  • an ultrasonic treatment tool including the ultrasonic probe can be provided.
  • FIG. 3 is a cross-sectional view schematically illustrating a configuration of a vibrator unit according to the first embodiment. It is a side view showing roughly the composition of the ultrasonic probe concerning a 1st embodiment. It is sectional drawing which shows roughly the structure of the front-end
  • FIG. 1 is a view showing an ultrasonic treatment system (ultrasonic treatment apparatus) 1 of the present embodiment.
  • the ultrasonic treatment system 1 includes an ultrasonic treatment tool 2.
  • the ultrasonic treatment instrument 2 has a longitudinal axis C.
  • One of the directions parallel to the longitudinal axis C is the distal direction (the direction of the arrow C1 in FIG. 1), and the opposite direction to the distal direction is the proximal direction (the direction of the arrow C2 in FIG. 1).
  • two directions (a distal direction and a proximal direction) parallel to the longitudinal axis C (along the longitudinal axis C) are defined as the longitudinal direction.
  • the ultrasonic treatment instrument 2 includes a transducer unit 3, a holding unit 5, a sheath 6, and an ultrasonic probe 7.
  • the holding unit 5 includes a cylindrical case portion 11 that extends along the longitudinal axis C.
  • An energy operation input button 12 that is an energy operation input unit is attached to the cylindrical case unit 11.
  • the vibrator unit 3 includes a vibrator case 13.
  • the vibrator unit 3 is connected to the holding unit 5 by inserting the vibrator case 13 into the cylindrical case portion 11 from the proximal direction side.
  • One end of a cable 15 is connected to the base end of the vibrator case 13.
  • the other end of the cable 15 is connected to the energy source unit 10.
  • the energy source unit 10 includes an ultrasonic energy source (ultrasonic power source) 16 and an energy control unit 18.
  • the energy source unit 10 is, for example, an energy generator (power generator), and the ultrasonic energy source 16 is a power source provided in the energy generator, for example.
  • the energy control unit 18 is provided in, for example, an energy generator, and is formed of a processor including a CPU (Central Processing Unit) or an ASIC (application specific integrated circuit).
  • a switch part (not shown) is provided inside the cylindrical case part 11.
  • the energy control unit 18 is electrically connected to the switch unit via a signal path (not shown) extending through the transducer case 13 and the cable 15.
  • the switch unit is closed, and the operation signal is transmitted to the energy control unit 18 through the signal path. Based on the transmitted operation signal, the energy control unit 18 controls the output state of ultrasonic generation energy (ultrasonic generation power) from the ultrasonic energy source 16.
  • FIG. 2 is a diagram showing a configuration of the vibrator unit 3.
  • the transducer unit 3 includes the above-described transducer case 13 and an ultrasonic transducer 21 that is a vibration generating unit provided inside the transducer case 13.
  • the ultrasonic transducer 21 includes a plurality (four in this embodiment) of piezoelectric elements 22A to 22D that convert electric current (alternating current) into ultrasonic vibration. For this reason, ultrasonic vibration is generated in the ultrasonic transducer 21 by supplying ultrasonic generation energy (ultrasonic generation power) to the ultrasonic transducer 21.
  • a horn member 23 extending along the longitudinal axis C is provided inside the vibrator case 13.
  • the horn member 23 includes a vibrator mounting portion 25.
  • a member for forming the ultrasonic vibrator 21 such as the piezoelectric elements 22A to 22D is attached to the vibrator mounting portion 25.
  • the horn member 23 is formed with a cross-sectional area changing portion 26. In the cross-sectional area changing portion 26, the cross-sectional area perpendicular to the longitudinal axis C becomes smaller toward the front end direction.
  • the cross-sectional area changing unit 26 increases the amplitude of the ultrasonic vibration.
  • a female screw portion 27 is provided at the tip of the horn member 23.
  • a male screw portion 28 is provided at the proximal end portion of the ultrasonic probe 7.
  • the ultrasonic probe 7 is connected to the distal direction side of the horn member 23.
  • the ultrasonic probe 7 extends along the longitudinal axis C.
  • the horn member 23 is connected to the ultrasonic probe 7 inside the cylindrical case portion 11.
  • the ultrasonic transducer 21 that is a vibration generating unit is located on the proximal direction side of the ultrasonic probe 7.
  • the sheath 6 is connected to the holding unit 5 by being inserted into the cylindrical case portion 11 from the distal direction side.
  • the sheath 6 is coupled to the transducer case 13 inside the cylindrical case portion 11.
  • the ultrasonic probe 7 is inserted through the sheath 6. For this reason, the distal end portion of the ultrasonic probe 7 protrudes from the distal end of the sheath 6 in the distal direction.
  • one end of electrical wirings 29 ⁇ / b> A and 29 ⁇ / b> B is connected to the ultrasonic transducer 21.
  • the electrical wirings 29 ⁇ / b> A and 29 ⁇ / b> B pass through the inside of the cable 15 and the other end is connected to the ultrasonic energy source 16 of the energy source unit 10.
  • ultrasonic power is supplied from the ultrasonic energy source 16 to the ultrasonic vibrator 21 via the electric wires 29A and 29B
  • ultrasonic vibration is generated in the ultrasonic vibrator 21.
  • the generated ultrasonic vibration is transmitted from the ultrasonic transducer 21 to the ultrasonic probe 7 via the horn member 23.
  • the horn member 23 and the ultrasonic probe 7 form a vibration transmission unit 20 that transmits ultrasonic vibration generated by the ultrasonic transducer 21 from the proximal direction to the distal direction.
  • the vibration transmission unit 20 vibrates in a predetermined vibration mode (vibration state) used during treatment by transmitting the ultrasonic vibration generated by the ultrasonic vibrator 21.
  • the vibration transmission unit 20 performs longitudinal vibration whose vibration direction is parallel to the longitudinal axis C (longitudinal direction).
  • the antinode position A1 located at the distal end of the vibration transmission unit 20 is located closest to the distal direction among the antinode positions of the longitudinal vibration
  • the antinode position A2 located at the proximal end of the vibration transmission unit 20 is the longitudinal vibration. It is located on the most proximal side among the antinodes.
  • the number of antinodes of longitudinal vibration and the number of node positions of longitudinal vibration between the distal end of the vibration transmission unit 20 and the proximal end of the vibration transmission unit 20 are fixed, and the vibration transmission unit There is at least one longitudinal vibration node position between the distal end of 20 and the proximal end of the vibration transmission unit 20.
  • the energy control unit 18 adjusts the resonance frequency of the vibration transmission unit 20 by adjusting the frequency of the current (alternating current) supplied to the ultrasonic transducer 21 and vertically moves the vibration transmission unit 20 in a predetermined vibration mode. It is vibrating.
  • the predetermined vibration mode (that is, the number of node positions and antinode positions of the longitudinal vibration) corresponds to the longitudinal dimension of the vibration transmission unit 20 used, the resonance frequency of the longitudinal vibration used for the treatment, and the like. It is determined.
  • FIG. 3 is a diagram showing the ultrasonic probe 7.
  • FIG. 4 is an enlarged view of the distal end portion of the ultrasonic probe 7.
  • first vertical direction the direction of the arrow P1 in FIGS. 3 and 4
  • first direction. 2 the direction of the arrow P2 in FIGS. 3 and 4
  • third vertical direction vertical upward direction with respect to the plane of FIG. 3 and FIG. 4.
  • FIG. 3 shows a state in which the ultrasonic probe 7 is viewed from the third vertical direction side
  • FIG. 4 shows a cross section perpendicular to the third vertical direction and the fourth vertical direction.
  • the ultrasonic probe 7 includes a probe main body 31 that extends along the longitudinal axis C.
  • the ultrasonic vibration transmitted to the ultrasonic probe 7 is transmitted from the proximal direction to the distal direction in the probe main body 31.
  • the longitudinal axis C of the ultrasonic treatment instrument 2 is the central axis of the probe main body 31. Therefore, the ultrasonic probe 7 has a longitudinal axis C that is the central axis of the probe main body 31.
  • a distal treatment section 32 is provided on the distal direction side of the probe main body 31. The distal treatment section 32 treats a treatment target such as a living tissue using the ultrasonic vibration transmitted through the probe main body section 31.
  • a distal end surface 33 of the ultrasonic probe 7 (vibration transmission unit 20) is formed by the distal treatment section 32.
  • the ultrasonic probe 7 is inserted into the sheath 6 with the distal treatment section 32 protruding from the distal end of the sheath 6 in the distal direction.
  • the antinode position A1 of the longitudinal vibration is located on the distal end surface 33.
  • a node position N1 located at the most distal end side among the node positions of the longitudinal vibration in the predetermined vibration mode is defined.
  • the node position N ⁇ b> 1 is located on the proximal end side with respect to the distal treatment portion 32 and is located on the probe main body portion 31. Therefore, the node position N1 of longitudinal vibration is located inside the sheath 6.
  • a hook portion 35 is provided in the distal treatment section 32 located on the distal direction side from the probe main body section 31.
  • the hook portion 35 is bent toward the first vertical direction side with respect to the probe main body portion 31 (longitudinal axis C). For this reason, the hook part 35 protrudes toward the first vertical direction in the distal treatment part 32.
  • Part of the distal end surface 33 of the ultrasonic probe 7 is formed by the hook portion 35.
  • a first base surface 36 which is a reference surface facing the first vertical direction, is provided on the outer surface of the ultrasonic probe 7 that faces the first vertical direction.
  • the first base surface 36 is located on the first vertical direction side from the longitudinal axis C.
  • the hook portion 35 protrudes in the first vertical direction with the first base surface 36 as a base surface. Therefore, a portion of the distal treatment section 32 that protrudes (positions) from the first base surface 36 toward the first vertical direction is the hook section 35.
  • an extended surface E1 obtained by extending the first base surface 36 toward the distal end side becomes a root cross section (hook base cross section) of the hook portion 35 protruding in the first vertical direction.
  • the first base surface 36 extends from the hook base end H1 that is the base end position of the hook portion 35 toward the base end.
  • the hook base end H ⁇ b> 1 is a bending start position (hook starting position) at which the hook portion 35 starts bending in the first vertical direction, and is a boundary position between the hook portion 35 and the first base surface 36.
  • the first base surface 36 extends through the outer surface of the probe main body 31. That is, a part of the outer surface of the probe main body 31 (a portion facing the first vertical direction) is formed by the first base surface 36, and the first base surface 36 is formed by the hook base end H1 (tip treatment). Extending from the portion 32) to the probe main body 31.
  • the hook tip H2 which is the tip position of the hook portion 35 is located on the tip surface 33 of the ultrasonic probe 7.
  • the hook portion 35 has a reference dimension L0 that is a dimension between the hook base end H1 and the hook front end H2 in the longitudinal direction.
  • the reference dimension L0 is a dimension (hook base dimension) in the longitudinal direction of the hook part 35 on the extended surface E1 which is a root cross section of the hook part 35. Therefore, the hook base end H1 is the base end position of the root cross section (E1) of the protruding portion of the hook portion 35 in the first vertical direction. That is, the hook base end H ⁇ b> 1 is a boundary position between the base of the protruding portion of the hook portion 35 and the first base surface (base surface) 36.
  • the distance (first surface distance) D1 from the longitudinal axis C to the first vertical direction is constant (uniform) within a predetermined dimension range (dimension) over the entire length in the longitudinal direction.
  • the design and the distance D1 from the longitudinal axis C to the first base surface 36 are the same over the entire length of the first base surface 36 in the longitudinal direction.
  • the distance D1 may not be the same over the entire length of the first base surface 36, resulting in minor changes.
  • the first base surface 36 in which the distance D1 from the longitudinal axis C to the first vertical direction is constant (uniform) within a predetermined size range is added to the case where the distance D1 is the same over the entire length.
  • the case where the distance D1 slightly changes due to an error in design and manufacturing is also included. That is, even when the distance D1 from the longitudinal axis C does not change by a predetermined amount or more over the entire length, it is the first base surface 36 in which the distance D1 from the longitudinal axis C is uniform within a predetermined dimension range. .
  • the distance D1 from the longitudinal axis C to the first vertical direction is, for example, ⁇ 0.1 mm or less over the entire length, the distance D1 from the longitudinal axis C is It is considered to be constant (uniform) within a given dimensional range.
  • a second base surface 41 serving as a reference surface facing the second vertical direction opposite to the first vertical direction is provided on the outer surface of the ultrasonic probe 7 that faces the second vertical direction.
  • the second basal surface 41 is located on the second vertical direction side from the longitudinal axis C.
  • the second basal surface 41 extends from the distal treatment section 32 toward the proximal direction.
  • the second base surface 41 extends through the outer surface of the probe main body 31. That is, a part of the outer surface of the probe main body 31 (a portion facing the second vertical direction) is formed by the second base surface 41, and the second base surface 41 extends from the distal treatment section 32 to the probe main body. It extends over the part 31.
  • a distance (second surface distance) D2 from the longitudinal axis C to the second vertical direction is constant (uniform) within a predetermined dimension range (dimension) over the entire length in the longitudinal direction.
  • the second base surface 41 in which the distance D2 from the longitudinal axis C to the second vertical direction is uniform within a predetermined size range is designed in addition to the case where the distance D2 is the same over the entire length.
  • a case where the distance D2 slightly changes due to an error in manufacturing is also included.
  • the distance D2 from the longitudinal axis C is the second base surface 41 that is uniform within a predetermined dimension range. . Therefore, on the second base surface 41, if the amount of change in the distance D2 from the longitudinal axis C to the second vertical direction is, for example, ⁇ 0.1 mm or less over the entire length, the distance D2 from the longitudinal axis C is It is considered to be constant (uniform) within a given dimensional range.
  • the distal treatment section 32 is provided with a protrusion 42 that protrudes in the second vertical direction with the second base surface 41 as a base surface. That is, a portion that protrudes (positions) from the second base surface 41 to the second vertical direction side in the distal treatment section 32 becomes the protrusion 42.
  • the protruding portion 42 is continuous with the distal direction side of the second base surface 41. Therefore, the second base surface 41 extends from the protrusion base end T1 that is the base end position of the protrusion 42 toward the base end.
  • the protrusion base end T ⁇ b> 1 of the protrusion 42 is a boundary position between the protrusion 42 and the second base surface 41.
  • the protruding portion 42 is positioned away from the hook portion 35 about the longitudinal axis C by an angular position of approximately 180 °. Further, in the present embodiment, the extended surface E2 obtained by extending the second base surface 41 toward the distal end side becomes a root cross section (protrusion root cross section) of the protrusion 42 protruding in the second vertical direction.
  • a part of the distal end surface 33 of the ultrasonic probe 7 is formed by the protrusion 42. Accordingly, the protrusion tip T2 that is the tip position of the protrusion 42 is located on the tip surface 33 of the ultrasonic probe 7.
  • the protrusion 42 has a protrusion width dimension S0 that is a dimension between the protrusion base end T1 and the protrusion tip T2 in the longitudinal direction.
  • the protrusion width dimension S ⁇ b> 0 is a dimension (protrusion root dimension) in the longitudinal direction of the protrusion 42 on the extended surface E ⁇ b> 2 that is a root cross section of the protrusion 42.
  • a cross section perpendicular to the longitudinal axis C passing through the hook base end H1 of the hook portion 35 is defined as a reference cross section Q0.
  • the protrusion 42 extends from the reference position B0 on the reference cross section Q0 in both the proximal direction and the distal direction. That is, the protruding portion 42 extends through the reference position B0.
  • the projection base end T1 that is the base end position of the projection 42 is located on the proximal direction side of the hook base end (hook start position) H1 of the hook 35
  • the projection tip that is the tip position of the projection 42 T ⁇ b> 2 is located on the distal direction side of the hook base end H ⁇ b> 1 of the hook portion 35.
  • the reference position B0 of the protrusion 42 is located apart from the hook base end H1 by an angular position of approximately 180 ° in the reference cross section Q0.
  • the protrusion 42 has a first extension dimension (first protrusion extension dimension) S1 from the reference position B0 to the protrusion base end T1 in the base end direction.
  • the first extending dimension S1 is at least half the reference dimension (hook base dimension) L0 of the hook portion 35 in the longitudinal direction from the hook base end H1 to the hook tip end H2. That is, the protruding portion 42 extends from the reference position B0 toward the proximal direction over the first extending dimension S1 that is equal to or greater than the half value L0 / 2 of the reference dimension L0.
  • the protrusion 42 has a second extension dimension (second protrusion extension dimension) S2 from the reference position B0 to the protrusion tip T2 in the tip direction.
  • the second extending dimension S2 is more than half the reference dimension (hook base dimension) L0 of the hook portion 35 in the longitudinal direction from the hook base end H1 to the hook tip end H2. That is, the protrusion 42 extends from the reference position B0 toward the distal end over the second extension dimension S2 that is equal to or greater than the half value L0 / 2 of the reference dimension L0. Since the first extension dimension S1 and the second extension dimension S2 are not less than the half value L0 / 2 of the reference dimension L0, the protrusion width dimension S0 of the protrusion 42 is larger than the reference dimension L0 of the hook part 35. It becomes.
  • the dimension in the second vertical direction from the second base surface 41 (extension surface E2) to the protrusion protruding end T3 which is the protruding end of the protrusion 42 is the second protrusion dimension (protrusion protrusion dimension) R2.
  • the first protrusion dimension R1 is larger than the second protrusion dimension R2.
  • the outer surface of the protrusion 42 is provided with a proximal-side projection surface 45 facing the proximal direction and a distal-side projection surface 46 facing the distal direction.
  • the proximal-side projecting surface 45 extends from the projecting proximal end T1 that is a boundary position between the projecting portion 42 and the second base surface 41 to the second vertical direction side.
  • the tip side protrusion surface 46 extends from the protrusion tip T2 to the second vertical direction side. A part of the distal end surface 33 of the ultrasonic probe 7 is formed by the distal end protrusion surface 46.
  • a protruding end surface 47 that forms a protruding protrusion end T ⁇ b> 3 that is a protruding end of the protruding portion 42 is provided on the outer surface of the protruding portion 42.
  • the protruding end surface 47 faces the second vertical direction.
  • a proximal-side curved surface 48 is continuous between the proximal-side protruding surface 45 and the protruding end surface 47, and a distal-side curved surface is interposed between the distal-side protruding surface 46 and the protruding end surface 47.
  • the surface 49 is continuous.
  • the proximal-side curved surface 48 and the distal-side curved surface 49 are curved surfaces formed in an arc shape in a plane perpendicular to the third vertical direction and the fourth vertical direction. Accordingly, the proximal-side curved surface 48 and the distal-side curved surface 49 are arcuate when viewed from the third vertical direction and when viewed from the fourth vertical direction.
  • the ultrasonic probe 7 and the ultrasonic treatment instrument 2 of the present embodiment will be described.
  • a treatment target such as a biological tissue (blood vessel)
  • the ultrasonic probe 7 and the sheath 6 are inserted into the body cavity.
  • the treatment target is hooked on the hook portion 35 of the distal treatment portion 32.
  • the treatment target comes into contact with the hook portion 35 from the proximal direction side.
  • An energy operation is input with the energy operation input button 12 in a state where the treatment target is hooked on the hook portion 35 from the proximal direction side.
  • the energy control unit 18 outputs ultrasonic generation energy (ultrasonic generation power) from the ultrasonic energy source 16.
  • ultrasonic generation energy (alternating current) is supplied to the ultrasonic vibrator 21
  • ultrasonic vibration is generated in the ultrasonic vibrator 21.
  • the generated ultrasonic vibration is transmitted to the ultrasonic probe 7 via the horn member 23.
  • ultrasonic vibration is transmitted from the proximal direction to the distal direction to the distal treatment section 32, and the vibration transmission unit 20 including the ultrasonic probe 7 vibrates longitudinally.
  • the distal treatment section 32 performs longitudinal vibration whose vibration direction is parallel to the longitudinal axis C while the treatment target is hooked on the hook section 35, the treatment target hooked on the hook section 35 is incised.
  • high-frequency power (high-frequency current) may be transmitted to the distal treatment section 32 simultaneously with the ultrasonic vibration.
  • the energy source unit 10 is provided with an energy source (power source or the like) different from the ultrasonic energy source 16, and high-frequency power (high-frequency energy) is output from the energy source.
  • the output high frequency power is supplied to the distal treatment section 32 through an electric wiring (not shown) different from the electric wirings 29A and 29B extending inside the cable 15, the horn member 23 and the ultrasonic probe 7.
  • high frequency power is supplied from an energy source to a counter electrode plate (not shown) arranged outside the body.
  • an ultrasonic probe 7A of a comparative example of this embodiment is shown in FIG.
  • a hook portion 35A is provided on the distal treatment portion 32A.
  • the hook portion 35A protrudes in the first vertical direction (the direction of the arrow P′1 in FIG. 5) using the first base surface 36A as the base surface.
  • the ultrasonic probe 7A is provided with a second base surface 41A that faces the second vertical direction (the direction of the arrow P′2 in FIG. 5).
  • the protrusion (42) is not provided.
  • the second base surface 41A extends toward the distal end direction up to the distal end surface 33A of the ultrasonic probe 7A.
  • the hook base end H′1 (hook base section) of the hook portion 35A is caused by the shape of the hook portion 35A. A moment centering around is generated. The generated moment causes the hook portion 35A to oscillate around the hook base end H′1 (hook base section).
  • FIG. 6 is a diagram for explaining the vibration state of the ultrasonic probe 7A when transmitting ultrasonic vibration.
  • the node position N′1 closest to the distal direction among the node positions of the longitudinal vibration is defined.
  • the portion on the distal direction side from the node position N′1 moves in the direction away from the node position N′1 by the longitudinal vibration (tip direction) (arrow in FIG. 6).
  • U′1 a moment (first moment) M′1 around the hook base end H′1 (hook base section) of the hook portion 35A is generated.
  • the hook portion 35A swings in the proximal direction about the hook proximal end H′1.
  • the moments M′1 and M′2 that swing the hook part 35A also act on parts other than the hook part 35A (parts on the second vertical direction side from the hook part 35A) in the distal treatment part 32A.
  • the moment M′1 acts the portion other than the hook portion 35A in the distal treatment section 32A moves in the second vertical direction.
  • the moment M′2 acts the portion other than the hook portion 35A moves in the first vertical direction in the distal treatment portion 32A.
  • the vibration direction in the distal treatment section 32A is perpendicular to the longitudinal axis C ′ (first Transverse vibrations (parallel to one vertical direction and the second vertical direction) occur.
  • first Transverse vibrations parallel to one vertical direction and the second vertical direction
  • the moments M′1 and M′2 act on the portion other than the hook portion 35A in the distal treatment section 32A, only the torsional vibration that vibrates around the longitudinal axis C and the surface of the ultrasonic probe 7 vibrate.
  • Surface acoustic wave vibration surface acoustic wave vibration
  • vibrations other than longitudinal vibrations such as transverse vibrations, torsional vibrations, and surface acoustic wave vibrations are referred to as inaccuracy vibrations.
  • the improper vibration generated by the moments M′1 and M′2 is transmitted from the distal treatment section 32A in the proximal direction.
  • the entire ultrasonic probe 7A performs improper vibration, and the vibration of the ultrasonic probe 7A becomes unstable.
  • the distal end treatment portion 32 of the ultrasonic probe 7 is provided with a protrusion 42 protruding in the second vertical direction.
  • the protrusion 42 extends from the reference position B0 on the reference cross section Q0 perpendicular to the longitudinal axis C passing through the hook base end H1 of the hook portion 35 in both the base end direction and the tip end direction.
  • the moment for swinging the hook portion 35 acts around the hook base end H1 of the hook portion 35. For this reason, the influence of the moment that swings the hook portion 35 on the distal treatment section 32 becomes large near the reference cross section Q0 including the reference position B0 and the reference cross section Q0.
  • the protrusion 42 extends in the longitudinal direction through the reference position B0 on the reference cross section Q0. For this reason, in the vicinity of the reference cross section Q0 and the reference cross section Q0 of the distal treatment section 32, the cross-sectional area perpendicular to the longitudinal axis C increases. Thereby, in the vicinity of the reference cross section Q0 and the reference cross section Q0 of the distal treatment section 32, the rigidity is increased, and the strength against the external force (moment) from the direction perpendicular to (crossing) the longitudinal axis C is increased. Therefore, even if a moment that swings the hook portion 35 is applied, a portion other than the hook portion 35 (a portion on the second vertical direction side from the hook portion 35) is difficult to move in the distal treatment section 32.
  • FIG. 7 is a diagram for explaining the vibration state of the ultrasonic probe 7 when transmitting ultrasonic vibration.
  • the position (tip end) in which the portion on the distal direction side from the node position (most node position) N1 of longitudinal vibration is separated from the node position N1 by longitudinal vibration.
  • a moment (first moment) M1 around the hook base end H1 (hook base section) of the hook portion 35 is generated.
  • the hook portion 35 swings in the proximal direction about the hook proximal end H1.
  • the rigidity is high in the vicinity of the reference cross section Q0 and the reference cross section Q0 of the distal treatment section 32 and is perpendicular to the longitudinal axis C ( Strength against external force (moment) from the direction of (intersect) increases. Even if the moment M1 acts on a portion other than the hook portion 35 in the distal treatment portion 32 (a portion on the second vertical direction side from the hook portion 35), the portion other than the hook portion 35 in the distal treatment portion 32 is the second portion. Does not move vertically. Similarly, even if the moment M2 is applied, portions other than the hook portion 35 in the distal treatment section 32 do not move in the first vertical direction.
  • the lateral vibration caused by the moments M1 and M2 that swing the hook portion 35 does not occur in the distal treatment portion 32.
  • torsional vibration and surface acoustic wave vibration due to the moments M1 and M2 do not occur in the distal treatment section 32.
  • the ultrasonic probe 7 does not perform unauthorized vibration. Therefore, in a state where ultrasonic vibration is transmitted, the ultrasonic probe 7 appropriately performs longitudinal vibration, and the stability of vibration in the ultrasonic probe 7 is ensured. As a result, the ultrasonic probe 7 can ensure the transmission of ultrasonic vibrations and can ensure the strength of the ultrasonic probe 7 with respect to the ultrasonic vibrations.
  • the protrusion 42 is a half L0 of the reference dimension (hook base dimension) L0 of the hook part 35 from the reference position B0 on the reference cross section Q0 perpendicular to the longitudinal axis C passing through the hook base end H1 toward the base end. It extends over the first extension dimension S1 of / 2 or more. Then, the protrusion 42 extends from the reference position B0 on the reference cross section Q0 toward the distal end over a second extension dimension S2 that is equal to or more than half L0 / 2 of the reference dimension L0 of the hook part 35. Yes.
  • the protrusion 42 is provided in a range in which the influence of the moments M1 and M2 that swing the hook portion 35 is large, that is, in a range over the reference dimension L0 with the hook base end H1 being the central position in the longitudinal direction. .
  • the rigidity is increased, and the strength against the external force (moment) from the direction perpendicular to (crossing) the longitudinal axis C is increased. .
  • the second base surface 41 is determined by the first protrusion dimension (hook protrusion dimension) R1 in the first vertical direction from the first base surface 36 (extension surface E1) to the hook protrusion end H3 of the hook portion 35.
  • the second protrusion dimension (protrusion protrusion dimension) R2 in the second vertical direction from the (extended surface E2) to the protrusion protrusion end T3 of the protrusion 42 becomes small. For this reason, even if the protrusion 42 is provided in the distal treatment section 32, the dimensions of the distal treatment section 32 in the first vertical direction and the second vertical direction can be reduced. Therefore, even if the distal treatment section 32 is provided with the protrusion 42, the distal treatment section 32 (ultrasonic probe 7) can be reduced in size.
  • the projecting portion 42 is provided with the proximal end side curved surface 48 and the distal end side curved surface 49, no corner is formed on the outer surface of the projecting portion 42. For this reason, even if the projection part 42 contacts a biological tissue etc. in the state which the ultrasonic probe is vibrating, damage to a biological tissue etc. can be prevented effectively.
  • a part of the distal end surface 33 of the ultrasonic probe 7 is formed by the protrusion 42, but the present invention is not limited to this.
  • an extending surface 51 may be provided on the distal direction side from the protrusion 42.
  • the extending surface 51 extends from the protrusion tip T2 of the protrusion 42 toward the distal end surface 33 of the ultrasonic probe 7 in the distal direction.
  • the protrusion tip T ⁇ b> 2 is a boundary position between the protrusion 42 and the extended surface 51.
  • the extending surface 51 faces the second vertical direction.
  • the extended surface 51 does not protrude from the second base surface 41 to the second vertical direction side.
  • the protrusion 42 extends through the reference position B0 on the reference section Q0 perpendicular to the longitudinal axis C passing through the hook base end H1 of the hook portion 35. That is, the protrusion 42 extends from the reference position B0 in both the proximal direction and the distal direction.
  • the first base surface 36 passes through the outer surface of the probe main body 31, but the present invention is not limited to this.
  • the concave surface 53 may be continuous between the outer surface of the probe main body 31 and the hook portion 35 in the longitudinal direction.
  • the concave surface 53 is recessed in the second vertical direction with respect to the outer surface of the probe main body 31 and the hook portion 35.
  • the concave surface 53 includes a concave bottom surface 55 that faces the first vertical direction.
  • the concave bottom surface 55 extends from the hook base end H1 of the hook portion 35 toward the base end direction.
  • the entire concave bottom surface 55 becomes the first base surface 36. Therefore, in the concave bottom surface 55 (first base surface 36), the distance D1 from the longitudinal axis C to the first vertical direction (first surface distance) D1 is constant within a predetermined dimension range over the entire length in the longitudinal direction. (Uniform).
  • the protrusion 42 extends through the reference position B0 on the reference section Q0 perpendicular to the longitudinal axis C passing through the hook base end H1 of the hook portion 35. That is, the protrusion 42 extends from the reference position B0 in both the proximal direction and the distal direction.
  • the ultrasonic probe (7) of the above-described embodiment extends along the longitudinal axis (C) and transmits ultrasonic vibration from the proximal direction (C2) to the distal direction (C1). And a hook that is provided on the distal direction (C1) side of the probe body portion (31) and is bent toward the first vertical direction (P1) side with respect to the probe body portion (31). Part (35). Part of the distal end surface (33) of the ultrasonic probe (7) is formed by the hook portion (35).
  • a first base surface (36) extends from the hook base end (H1), which is the base end position of the hook portion (35), in the base end direction (C2), and the first base surface (36).
  • the distance (D1) from the longitudinal axis (C) to the first basal surface (36) in the first vertical direction (P1) is constant (uniform) in a predetermined dimensional range over the entire length in the longitudinal direction.
  • the protrusion (42) is continuous with the tip direction (C1) side of the second base surface (41) facing the second vertical direction (P2), and the protrusion (42) is the second base. It protrudes toward the second vertical direction (P2) with the surface (41) as the base surface.
  • the protrusion (42) extends from the reference position (B0) on the cross section (Q0) perpendicular to the longitudinal axis (C) passing through the hook base end (H1) of the hook portion (35) to the base end direction (C2) and the tip end. It extends toward the direction (C1).

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Abstract

La présente invention concerne une sonde ultrasonore qui comporte une partie crochet qui est courbée par rapport à une partie corps de sonde vers un premier côté de direction verticale et forme une partie d'une surface de pointe, et une première surface de base qui s'étend à partir d'une extrémité de base de crochet de la partie crochet vers une direction d'extrémité de base et forme la surface de base de la partie crochet. La sonde ultrasonore comporte une partie saillante qui fait saillie vers une seconde direction verticale, qui est opposée à la première direction verticale, tout en ayant en tant que surface de base une seconde surface de base tournée vers la seconde direction verticale, et s'étend, à partir d'une position de référence sur une section transversale qui est perpendiculaire à un axe longitudinal qui passe à travers l'extrémité de base de crochet, vers la direction d'extrémité de base et la direction d'extrémité de pointe.
PCT/JP2015/068335 2014-07-10 2015-06-25 Sonde ultrasonore et dispositif de traitement par ultrasons WO2016006463A1 (fr)

Priority Applications (4)

Application Number Priority Date Filing Date Title
EP15819625.3A EP3167832B1 (fr) 2014-07-10 2015-06-25 Sonde ultrasonore et dispositif de traitement par ultrasons
CN201580017413.3A CN106132327B (zh) 2014-07-10 2015-06-25 超声波探头和超声波处理器具
JP2016506020A JP5970142B2 (ja) 2014-07-10 2015-06-25 超音波プローブ及び超音波処置具
US15/265,959 US10064641B2 (en) 2014-07-10 2016-09-15 Ultrasonic probe and ultrasonic treatment instrument

Applications Claiming Priority (2)

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JP2014-142630 2014-07-10
JP2014142630 2014-07-10

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US15/265,959 Continuation US10064641B2 (en) 2014-07-10 2016-09-15 Ultrasonic probe and ultrasonic treatment instrument

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USD974558S1 (en) 2020-12-18 2023-01-03 Stryker European Operations Limited Ultrasonic knife

Citations (3)

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JPH08503621A (ja) * 1992-02-03 1996-04-23 ウルトラシジョン インコーポレーテッド 超音波外科手術用ブレード及びこのブレードの使用方法
JP2007054665A (ja) * 2006-12-04 2007-03-08 Olympus Corp 外科手術用処置具
JP5555392B1 (ja) * 2012-09-24 2014-07-23 オリンパスメディカルシステムズ株式会社 超音波作動ユニット及び超音波処置装置

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Publication number Priority date Publication date Assignee Title
WO2008118709A1 (fr) 2007-03-22 2008-10-02 Ethicon Endo-Surgery, Inc. Lame pour instrument chirurgical à ultrasons
WO2012121213A1 (fr) * 2011-03-09 2012-09-13 オリンパスメディカルシステムズ株式会社 Dispositif de traitement bipolaire

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Publication number Priority date Publication date Assignee Title
JPH08503621A (ja) * 1992-02-03 1996-04-23 ウルトラシジョン インコーポレーテッド 超音波外科手術用ブレード及びこのブレードの使用方法
JP2007054665A (ja) * 2006-12-04 2007-03-08 Olympus Corp 外科手術用処置具
JP5555392B1 (ja) * 2012-09-24 2014-07-23 オリンパスメディカルシステムズ株式会社 超音波作動ユニット及び超音波処置装置

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Publication number Publication date
CN106132327B (zh) 2019-06-07
EP3167832A4 (fr) 2018-04-04
EP3167832B1 (fr) 2022-06-08
US10064641B2 (en) 2018-09-04
JP5970142B2 (ja) 2016-08-17
CN106132327A (zh) 2016-11-16
EP3167832A1 (fr) 2017-05-17
US20170000514A1 (en) 2017-01-05
JPWO2016006463A1 (ja) 2017-04-27

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